Article
Successful implementation of spacer treatment guideline for acute
asthma
C V E Powella, G R Maskellc, M K Marksd, M Southd, C F Robertsonb
a Department of
Emergency Medicine, Royal Children's Hospital, Flemington Road,
Parkville, Victoria 3052, Australia, b Department of Thoracic Medicine, Royal
Children's Hospital, c Hospital Support Unit, Royal Children's
Hospital, d Department
of Paediatrics, University of Melbourne, Australia
Correspondence to: Dr Powell powellc{at}cryptic.rch.unimelb.edu.au
Accepted 9 August 2000
AIMS
To develop and implement an
evidence based guideline for the treatment of acute asthma using a
metered dose inhaler and spacer combination.
METHODSDefined strategies were
used for the development and implementation of a guideline, assessed by
a prospective, descriptive, study using notes review, and patient,
nursing, and medical staff telephone contact. The setting was a
tertiary referral hospital in Victoria, Australia with 25 000 yearly
admissions, and asthma accounting for about 7% of total. The first 200 children and families to use the guideline after its introduction were evaluated.
RESULTSA total of 191 (95.5%)
children were treated according to the guideline. Six (3.0%) children
were given nebulisers appropriately based on severity; five (2.5%)
were given nebulisers at parental or child choice; and four (2.0 %)
who did not have severe asthma, received nebulised treatment inappropriately.
CONCLUSIONSSuccessful
implementation of a new evidence based guideline can be achieved using
specific strategies for promoting the application of research findings
in the clinical arena.
Keywords: acute asthma; spacers; evidence based guideline; change in practice
© 2001 by Archives of Disease in Childhood
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